摘要
糖尿病黄斑水肿(DME)是一种严重威胁视力,甚至致盲的眼病,主要表现为糖尿病引起的黄斑中心凹处视盘直径范围内细胞外液积聚引起的视网膜增厚和硬性渗出。DME的发生和发展是多因素参与的复杂病理生理过程,其中血管内皮生长因子(VEGF)生成增加是影响DME发展的重要原因之一。基于大量临床研究中多种抗VEGF药物(哌加他尼钠、贝伐单抗、雷珠单抗、阿柏西普、康柏西普和布洛赛珠单抗)在DME治疗中显现出的良好疗效及安全性,抗VEGF药物已成为DME的一线治疗方案。对于难治性DME,及时更换药效更强的抗VEGF药物或糖皮质激素在研究中显示出临床获益。抗VEGF药物对治疗依从性和长期治疗费用的高要求可能是困扰DME患者的问题,按需治疗策略及治疗-延长策略不失为减轻DME患者治疗负担的一种选择。随着医药研发产业的飞速发展,更多新型抗VEGF药物(如法瑞西单抗、IBI-302等)的诞生将为DME患者治疗带来新的选择。本文就抗VEGF药物治疗DME的研究进展进行综述。
Diabetic macular edema(DME)is a severe,sight-threatening condition.It mainly presents as retinal thickening and hard exudates caused by the accumulation of extracellular fluid within the diameter of the optic disc in the macula fovea caused by chronic hyperglycemia.The pathogenesis of DME is a complex process involving various contributing factors,with the elevated release of vascular endothelial growth factor(VEGF)being one of the important reasons.Anti-VEGF drugs,including pegaptanib sodium,bevacizumab,ranibizumab,aflibercept,conbercept,and brolucizumab,are the first-line therapy for treating DME due to the satisfying efficacy and safety demonstrated in numerous clinical studies.For refractory DME,timely switching to different anti-VEGF drugs or adopting corticosteroid-based treatments appears promising.Although the compliance and cost-effectiveness of anti-VEGF drugs may be a heavy burden for DME patients,pro re nata and treat&extend strategy might help.With the rapid development of the pharmaceutical industry,new anti-VEGF drugs(such as faricilumab and IBI-302)may offer broader therapeutic prospects for treating DME.This article reviews updates on anti-VEGF treatment for DME.
作者
赵清(综述)
陈有信(审校)
Zhao Qing;Chen Youxin(Department of Ophthalmology,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《中华实验眼科杂志(中英文)》
北大核心
2025年第8期766-776,共11页
Chinese Journal Of Experimental Ophthalmology
作者简介
通信作者:陈有信,Email:chenyx@pumch.cn。
